Inhaling v Ingesting Medical Cannabis: What’s The Difference? 

 

Research has shown that there are some pretty significant differences, and medical reasons between both of these methods, and it's not about getting high.  And that’s a good thing, because understanding the differences will allow you to discuss the different treatment options with your doctor, and why inhalation may be a better treatment option for your symptoms. 

 

There are two main differences

 

The first difference has to do with the way your body processes THC. The difference between inhaling and eating: the effect you get from smoking or vaping cannabis tends to be almost immediate and dissipates quicker, while the effect you get from eating takes longer to set in depending how much is consumed and the effects are usually more intense and last longer.

 

When you inhale cannabis, the THC gets into your body rapidly, with as much as 50 to 60 percent of the chemical going straight into your blood plasma. Ultimately, the THC in the bloodstream goes straight to your brain to produce an instant effect. This entire process happens quickly, but it also wears off pretty quickly.

 

However, when you ingest cannabis, you send the THC on an entirely different metabolic route, which creates a significantly different experience.

 

Mitch Earleywine, professor of psychology, State University of New York, and the author of Understanding Marijuana describes the process of metabolising cannabis when it’s taken orally as:

 

“In a nutshell, eaten cannabis gets metabolized by the liver, so delta-9 THC becomes 11-hydroxy-THC, which passes the blood-brain barrier more rapidly and has more of a psychedelic effect than standard THC.”

 

“Smoked or vaporized cannabis bypasses the liver and doesn’t create the same 11-hydroxy-THC.”

 

To put it in simpler terms, when you eat cannabis, the THC passes through your liver before entering your bloodstream. In effect this gives a “double effect,” as the THC affects your body when it hits the liver and again when it gets into the bloodstream.

 

This process takes a bit longer, which is why it takes longer to get an affect from taking cannabis orally, but once it happens, the “double affect” it produces tends to last longer and can often be more intense than the affect produced by smoking or vaporising.

 

The second reason there are differences between inhaling and ingesting cannabis has to do with what’s often called “set and setting.”  This has more to do with the environmental factors and why people might perceive the effects of ingesting cannabis to be more intense also has to do with set and setting.”

 

“As the effects of smoked cannabis can be felt within seconds, even mildly experienced users can generally pick the point where they’ve had enough, a process called ‘titration.'”

 

In contrast, those who ingest cannabis need to estimate what the dose they’ve taken will do, and the length of the affect means that any unpleasant side effects take longer to go away.

 

The justification for inhalation is that the rapid effect from smoking or vaping makes it easier for a patient to know when they’ve had enough, while the slower-working and longer acting effect of ingesting cannabis can make dosages harder to figure out, and the patient ends up ingesting more than they need or would have inhaled because they’re unsure of what effect they’ll obtain when the cannabis has fully metabolised. By the time the cannabis takes effect, the patient may find that they’ve ingested more than they need.

 

Donald Abrams,  M.D. Chief of Hematology-Oncology, San Francisco General Hospital; Professor of Clinical Medicine, University of California, San Francisco explains why smoked plant matter has properties that help the body heal, as does vaporized (non-combusted plant matter).

 

"The operative word is plant, not the pill (form of THC). After we demonstrated that cannabis had a medicinal use. We knew people were against smoking a medicine. My colleagues say Donald, nobody smokes fox glove we have digitalis you know, using a whole plant as medicine is sort of archaic. Well actually my interest in cannabis, that also got me interested in integrated medicine, particularly in traditional Chinese medicine where many treatments that are used are herbal concoctions or decoctions where the whole plant is used. In Chinese medicine extracting the active component and using that as a drug would be sort of unheard of because it removes it from the yin and the yang, the balance , provided by nature when the medicine was given as a plant. So we knew that we could demonstrate smoking cannabis was effective till we were blue in the face and nobody was going say that it should be approved because of the delivery system. So the institute of medicine report in 1999 suggested that people seek other rapid onset delivery system for delivering cannabis as a medicine. So we did a clinical trial looking at a vaporizer and comparing the levels of cannabinoids that developed in the blood stream after smoking a cannabis cigarette verses vaporizing the same cigarette. We did this in healthy marijuana smoking volunteers aged 25 40. It was the fastest clinical trial I had ever done because we had people lined up, very easy to enroll. What we proved was that the levels of cannabinoids in the blood stream were equivalent whether it was smoked or vaporized. That there was much less exposure to noxious gasses, when it was vaporized as measured by expired carbon monoxide. That the high was graded as equal and the patients actually had a preference for vaporization."